Diabetic neuropathy, a common complication of
diabetes, is damage to the nerves that allow you to
feel sensations such as pain. There are a number of
ways that diabetes damages the nerves, but they all
seem related to blood glucose being too high for a
long period of time.

Diabetes-related
nerve damage can be painful, but it isn't severe
pain in most cases.
There are four types of diabetic neuropathy:
peripheral, autonomic, proximal and focal.

1)
Diabetic Peripheral Neuropathy

The areas of the body most commonly affected by
diabetic peripheral neuropathy are the feet and
legs. Nerve damage in the feet can result in a loss
of foot sensation, increasing your risk of foot
problems. Injuries and sores on the feet may go
unrecognized due to lack of sensation. Therefore,
you should practice proper skin and foot care.
Rarely, other areas of the body such as the arms,
abdomen, and back may be affected.

Symptoms of
diabetic peripheral neuropathy may include:

Tingling

Numbness
(severe or long-term numbness can become
permanent)

Burning
(especially in the evening)

Pain

In most cases,
early symptoms will become less when blood glucose
is under control. Medications can be taken to help
control the discomfort if needed.

To prevent
peripheral neuropathy:

Work with your doctor to keep
your blood glucose under tight control

To
help prevent the complications of peripheral
neuropathy:

Examine your
feet and legs daily

Apply lotion
if your feet are dry

Care for your
nails regularly. (Go to a podiatrist, if
necessary)

Wear properly
fitting footwear and wear them all the time to
prevent foot injury.

Treatments of autonomic neuropathy of the digestive
system may include:

Eat smaller meals

Medicines

Symptoms of autonomic neuropathy of the blood
vessels may include:

Blacking out when you stand up
quickly

Increased heart rate

Dizziness

Low blood pressure

Treatments of autonomic neuropathy of the blood
vessels may include:

Avoid standing up too quickly

Medicines

Wearing special stockings

Symptoms of autonomic neuropathy of the male sex
organs may include:

Unable to have or maintain an
erection (erectile dysfunction)

Dry or reduced ejaculations

Note: Impotence needs
to be evaluated by your doctor. It may be caused by
your medicines or factors other than diabetes.

Symptoms of autonomic neuropathy of
the female sex organs may include:

Decrease in vaginal lubrication

Decrease in number of orgasms or
lack of orgasm

Treatments of autonomic neuropathy of
the female sex organs include:

Counseling

Vaginal estrogen creams,
suppositories and rings

Lubricants

Symptoms of autonomic neuropathy of
the urinary system may include:

Unable to completely empty
bladder

Bloating

Incontinence (leaking urine)

Increased urination at night

3)
Diabetic Proximal Neuropathy

Diabetic proximal neuropathy causes pain (usually on
one side) in the thighs, hips, or buttocks. It can
also lead to weakness in the legs. Treatment for
weakness or pain is usually needed and may include
medication and physical therapy. The recovery
varies, depending on the type of nerve damage.
Prevention consists of keeping blood glucose under
tight control.

4)
Diabetic Focal Neuropathy

Diabetic neuropathy can also appear suddenly and
affect specific nerves, most often in the head,
torso, or leg, causing muscle weakness or pain. This
is known as focal neuropathy. Symptoms may include:

double vision

eye pain

paralysis on one side of the face
(Bell's palsy)

severe pain in a certain area,
such as the lower back or leg(s)

chest or abdominal pain that is
sometimes mistaken for another condition such as
heart attack or appendicitis

Focal neuropathy is painful and unpredictable,
however, it tends to improve by itself over weeks or
months and does not tend to cause long-term damage.

Other
Nerve Conditions Seen With Diabetes

People with diabetes can also develop other
nerve-related conditions, such as nerve compressions
(entrapment syndromes).

Carpal tunnel syndrome is a very common type of
entrapment syndrome and causes numbness and tingling
of the hand and sometimes muscle weakness or pain.

Prevention of Diabetic Neuropathy

Keeping tight control of your blood sugar levels
will help prevent many of these diabetes-related
nerve conditions. Talk to your doctor about
optimizing your individual diabetes treatment plan.

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